IMPORTANT !!!
IF YOU ARE PLANNING TO GRADUATE SUMMER SEMESTER,
YOUR GRADUATION PETITION * MUST * BE RECEIVED
AT THE CASHIER’S OFFICE WITH THE $35.00
GRADUATION FEE BY 5 P.M. MONDAY, JUNE 12, 2017
ANY PETITIONS RECEIVED
AFTER THE DUE DATE WILL BE PROCESSED FOR THE FOLLOWING SEMESTER.
GRADUATION POLICY
1.) The graduation fee of $35 must accompany this form and be paid to the
Cashier’s Office.
2.) It is the sole obligation of the student to complete this form. No degrees can
be issued without it. A late request will be treated as a request for the
following semester. Students whose requests are denied must re-petition
in a subsequent semester when academic requirements are met.
3.) Students must be in good academic standing in order to graduate. In order to
graduate with honors, students must have a 3.50 or higher cumulative grade
point average at the end of their last semester. See college catalog for
details.
4.) Students who petition for graduation will have their files reviewed by the
Registrar and the appropriate Dean between weeks three and five of their last
semester. Students are notified by mail about their graduation status after the
files are reviewed.
5.) Students must have curriculum requirements, other than current semester
enrollment, completed by the end of the fifth week of the semester in
order to maintain eligibility for graduation at the end of that semester. Any
credit procedure not completed prior to the deadline will require repetitioning in a subsequent term.
6.) At the end of each academic term, all degrees will be mailed to approved
candidates four weeks after grades are released following the end of the term.
All successful candidates may elect to attend the commencement ceremony,
held in May each year. Caps and gowns will be worn for the May ceremony.
7.) THE DEGREE REQUEST FORM IS DUE AT THE END OF THE
SECOND WEEK OF THE SEMESTER IN WHICH YOU INTEND TO
GRADUATE.
DEGREE REQUEST FORM
INSTRUCTIONS
Note:
If you check more than one box per technology (example: Business Management and Financial Management), only one degree
can be certified, one fee charged, and one diploma generated. However, the second major will appear on your official transcript.
ASSOCIATE DEGREES AND DIPLOMAS
Today’s Date
(Please PRINT your name exactly as it should appear on your DEGREE or DIPLOMA)
Full
Name:
First
Street
Middle
Check box if this is a new address
Social Security Number
Last
City
State
Phone Number
Zip
County
Signature
ASSOCIATE DEGREES/DIPLOMA PROGRAMS (Check One)
Liberal Arts, Professional
Services (AA/AS Degrees)
Associate of Arts
Business Administration- AA
Communications - AA
Criminal Justice - AA
Education - AA
English - AA
Liberal Arts - AA
Paralegal Studies - AA
Philosophy - AA
Psychology - AA
Social Work - AA
Business, Industry & Technology
(AAB/AAS Degrees)
Accounting
Business Administration
Business Management
Marketing Option
Information Technology
Information Tech – Cyber Security
Information Tech - Networking
Information Tech – Software Dev
Criminal Justice
Criminal Justice Option
Criminal Justice Law Enforcement Opt
Associate of Science
Accounting - AS
Business Administration - AS
Computer Science - AS
Criminal Justice - AS
Forensic Science - AS
Mathematics - AS
Mortuary Science - AS
Pre-Professional Studies – AS
Science/Medical Academy - AS
GRADUATION DATE:
Early Childhood Education
Electronic Engineering
Human Services
Industrial Technology
Electrical Maintenance Option
Engineering Design
Integrated Engineering Technology
Manufacturing Technology
Manufacturing Tech Operations Mgt
Tool and Die Option
(GRADUATION CEREMONY IS AFTER SPRING TERM)
SPRING
I WILL BE ATTENDING THE CEREMONY
SUMMER
Business, Industry &
Technology (Continued)
Mechanical Engineering Tech
Paralegal Studies
Visual Comm Graphic Design
Visual Comm Video Product
Health Sciences-AAS Degree
Bioscience Technology
Health Services Technology
Occupational Therapy
Physical Therapist Assistant
Registered Nursing
Radiological Sciences
Respiratory Care
Certificate Program
Practical Nursing
Technical Studies
Interdisciplinary Studies
FALL
I WILL NOT BE ATTENDING THE CEREMONY
TO: All Students Petitioning to Graduate
FROM: Caitlin Rethorst, Career Counselor
RE: Authorization To Release Information
The College is required to gather information from employers to evaluate our graduates’ preparedness for the
workplace. The information gathered is used to make curricular decisions, to ensure continuing accreditation
for academic programs, and to assess our effectiveness as an institution. The following release of information
statement gives the College permission to contact your employer for the purposes of collecting this very
important data.
This release of information, made between North Central State College and the undersigned
individual, shall commence on the date of signature below and conclude after 40 months. The
current or past employer is hereby authorized to furnish and release to North Central State
College all information pertinent to position related functions that shall be requested. A
photostatic or electrostatic copy shall have the same authority as the original.
I,___________________________________, have read and understand this
(Student/Graduate Name – PLEASE PRINT)
authority to release information.
______________________________
MAJOR
_______________________________________
SOCIAL SECURITY NUMBER
______________________________
DATE
_______________________________________
SIGNATURE
________________________________________________________________________
Personal E-mail Address
Attention Transfer Students
If you are interested in transferring to The Ohio State University –
Mansfield Campus please complete the following and submit it with your
graduation petition:
Name: ______________________________________
Phone: ______________________________________
E-mail: ______________________________________
Major at NC State College: _______________________
Intended Major at OSU: _________________________
This information will be forwarded to an OSU advisor so they can assist
you with the steps necessary for transfer.
____________________________________________________________
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